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1 EMR Name/ Model EMR Vendor Cerner PowerChart Ambulatory (PowerWorks ASP) Cerner Corporation Core Set of Measures 1 Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines More than 30% of unique patients with at least one medication in their medication list seen by the EP or admitted to the eligible hospital s or CAH s inpatient or emergency department (POS 21 or 23) have at least one medication order entered using CPOE Yes. This is available through electronic orders in PowerChart Ambulatory EHR. 2 Implement drug-drug and drug-allergy interaction checks Implement drug-drug and drug-allergy interaction checks The EP/eligible hospital/cah has enabled this functionality for the entire EHR reporting period Multum MediSource drug database is used. 3 Generate and transmit permissible prescriptions electronically (erx). More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology. Yes. eprescribing is a built-in feature of the EHR.

2 4 5 Record demographics o preferred language o gender o race o ethnicity o date of birth Maintain an up-to-date problem list of current and active diagnoses Record demographics o preferred language o gender o race o ethnicity o date of birth o date and preliminary cause of death in the event of mortality in the eligible hospital or CAH Maintain an up-to-date problem list of current and active diagnoses More than 50% of all unique hospital s or CAH s inpatient or 21 or 23) have demographics recorded as structured data More than 80% of all unique hospital s or CAH s inpatient or 21 or 23) have at least one entry or an indication that no problems are known for the patient recorded as structured data. Yes. These demographics can either be documented in the EHR, or they can automatically flow through to the EHR via an interface to a practice management (PM) system. Yes. This is available through the problem list in the EHR. 6 Maintain active medication list Maintain active medication list More than 80% of all unique hospital s or CAH s inpatient or 21 or 23)have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data Yes. The EHR contains an active medication list.

3 7 Maintain active medication allergy list Maintain active medication allergy list More than 80% of all unique hospital s or CAH s inpatient or 21 or 23) have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data Yes. The EHR contains an allergy list. 8 Record and chart changes in vital signs: o Height o Weight o Blood pressure o Calculate and display BMI o Plot and display growth charts for children 2-20 years, including BMI Record and chart changes in vital signs: o Height o Weight o Blood pressure o Calculate and display BMI o Plot and display growth charts for children 2-20 years, including BMI For more than 50% of all unique patients age 2 and over seen by the EP or admitted to eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23), height, weight and blood pressure are recorded as structured data 9 Record smoking status for patients 13 years old or older Record smoking status for patients 13 years old or older More than 50% of all unique patients 13 years old or older seen by the EP or admitted to the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23) have smoking status recorded as structured data

4 10 Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance that rule Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance that rule Implement one clinical decision support rule 11 Report ambulatory clinical quality measures to CMS or the States Report hospital clinical quality measures to CMS or the States For 2011, provide aggregate numerator, denominator, and exclusions through attestation as discussed in section II(A)(3) of this final rule Yes. Currently, the PowerWorks Advanced Reporting (PAR) standard package can be used for 2011 self-attestation. For 2012, electronically submit the clinical quality measures as discussed in section II(A)(3) of this final rule Yes, this will be available. 12 Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), upon request Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), upon request More than 50% of all patients of the EP or the inpatient or emergency departments of the eligible hospital or CAH (POS 21 or 23) who request an electronic copy of their health information are provided it within 3 business days Yes. This is available through Cerner's patient portal solution, which is included in our meaningful use package.

5 13 Provide patients with an electronic copy of their discharge instructions at time of discharge, upon request More than 50% of all patients who are discharged from an eligible hospital or CAH's inpatient department or 21 or 23) and who request an electronic copy of their discharge instructions are provided it Yes. This is available through Cerner's patient portal solution, which is included in our meaningful use package. 14 Provide clinical summaries for patients for each office visit Clinical summaries provided to patients for more than 50% of all office visits within 3 business days 15 Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, diagnostic test results), among providers of care and patient authorized entities electronically Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, diagnostic test results), among providers of care and patient authorized entities electronically Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information Yes. Continuity of Care Documents (CCDs) can be rendered and sent by the system in accordance with necessary standards. Capabilities are available in the EHR for generating and storing a CCD. The ability to accept a CCD is available through Cerner's consumer portal. 16 Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities Conduct or review a security risk analysis per 45 CFR (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process Appropriate technical capabilities are part of all Cerner solutions. Menu Set of Measures

6 Eligible Professionals Eligible Hospitals and CAHs 17 Implement drug-formulary checks Implement drug-formulary checks The EP/eligible hospital/cah has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting period Multum MediSource drug database is used. 18 Record advance directives for patients 65 years old or older More than 50% of all unique patients 65 years old or older hospital's or CAH's inpatient department (POS 21) have an indication of an advance directive status recorded 19 Incorporate clinical lab-test results into certified EHR technology as structured data Incorporate clinical lab-test results into certified EHR technology as structured data Incorporate clinical lab-test results into certified EHR technology as structured data Incorporate clinical lab-test results into certified EHR technology as structured data More than 40% of all clinical lab tests results ordered by the EP or by an authorized provider of the eligible hospital or CAH for patients admitted to its inpatient or 21 or 23) during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data Yes. This is available in the EHR via an inbound lab interface.

7 20 Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach Generate at least one report listing patients of the EP, eligible hospital or CAH with a specific condition Yes. This is available through PowerWorks Advanced Reporting (PAR), Standard Package. 21 Send reminders to patients per patient preference for preventive/ follow up care More than 20% of all unique patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period This is future functionality. Anticipated release is Q Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, medication allergies) within four business days of the information being available to the EP More than 10% of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP's discretion to withhold certain information Yes. This is available through Cerner's patient portal solution, which is included in our meaningful use package. 23 Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate More than 10% of all unique hospital's or CAH's inpatient or 21 or 23) are provided patientspecific education resources Yes. This is available through the EHR in conjunction with ExitCare or Krames.

8 24 CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation CAH performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP or admitted to the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23) 25 CAH who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary of care record for each transition of care or referral CAH who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary of care record for each transition of care or referral CAH who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50% of transitions of care and referrals Patient care summaries can currently be printed/faxed. Continuity of Care Documents (CCDs) can be rendered and sent by the system in accordance with necessary standards. Capabilities are available in the EHR for generating and storing a CCD. The ability to accept a CCD is available through Cerner's consumer portal. 26 data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice Performed at least one test of certified EHR technology's capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP, eligible hospital or CAH submits such information have the capacity to receive the information electronically) Yes. Cerner currently submits to immunization registries in 7 states. Submission to immunization registries in all states is anticipated for Q

9 27 data on reportable (as required by state or local law) lab results to public health agencies and actual submission in accordance with applicable law and practice Performed at least one test of certified EHR technology's capacity to provide electronic submission of reportable lab results to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which eligible hospital or CAH submits such information have the capacity to receive the information electronically) Yes. Full functionality will be available in Q syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP, eligible hospital or CAH submits such information have the capacity to receive the information electronically)

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